Cases reported "Mycobacterium Infections"

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1/44. mycobacterium fortuitum spinal infection: case report.

    Acute paraplegia followed a vertebral infection with mycobacterium fortuitum. There was a satisfactory response to surgery and antibiotics. No predisposing factors for this primary bone infection could be found.
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2/44. Bone abscess due to mycobacterium xenopi.

    Destructive infection of a cuneiform bone due to M. xenopi is described. The organism was isolated and its significance established by a strong skin reaction to xenopi antigen and by demonstration of bacilli in the lesion with fluorescence microscopy. This evidence of metastatic disease suggests that an alimentary route of infection as an alternative to inhalation could be considered.
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3/44. Detecting mycobacteria in Romanowsky-stained cytologic smears. A case report.

    BACKGROUND: Cytologic features of mycobacterial infections are granulomatous inflammation with or without caseous necrosis and the demonstration of acid-fast bacilli with special stains. However, immuno-compromised patients might not mount the expected response. CASE: A routinely used Romanowsky (Leishman) stain was used for the presumptive diagnosis of mycobacterial infection in a 30-year-old man with AIDS. The mycobacteria were identified as inclusions, described as "negative images," in the cytoplasm of macrophages in smears of bone marrow aspirate. They were then confirmed to be acid-fast bacilli with Ziehl-Neelsen stain. CONCLUSION: Negative images of mycobacteria may be seen in Romanowsky-stained cytologic smears from patients with immunodeficiency. This is a rapid and cost-effective way of detecting the mycobacteria before more specific results are available. Such a search should be undertaken routinely in all patients suspected to have such infections.
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ranking = 98.720042360285
keywords = macrophage, bone
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4/44. Safe inoculation of blood and bone marrow for liquid culture detection of mycobacteria.

    BACKGROUND: needlestick injuries confer an unnecessary risk of occupational bloodborne infections such as human immunodeficiency virus (hiv), hepatitis b virus (HBV) and hepatitis c virus (HCV) infections. After an accidental needlestick injury, procedures for inoculation of liquid culture media for rapid detection of mycobacterium tuberculosis complex and other mycobacteria from blood and bone marrow specimens were reviewed. AIM: To identify a safer transfer device, which could replace the ordinary syringe in inoculation of liquid culture vials. methods: We identified a transfer device to transfer blood or bone marrow specimens from bedside tubes into liquid culture vials. CONCLUSION: The changed procedure will reduce the risk of needlestick accidents and be of benefit to other microbiological laboratories using the same or similar inoculation techniques.
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keywords = bone
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5/44. Acquired predisposition to mycobacterial disease due to autoantibodies to IFN-gamma.

    Genetic defects in the IFN-gamma response pathway cause unique susceptibility to intracellular pathogens, particularly mycobacteria, but are rare and do not explain mycobacterial disease in the majority of affected patients. We postulated that acquired defects in macrophage activation by IFN-gamma may cause a similar immunological phenotype and thus explain the occurrence of disseminated intracellular infections in some patients without identifiable immune deficiency. macrophage activation in response to IFN-gamma and IFN-gamma production were studied in whole blood and PBMCs of 3 patients with severe, unexplained nontuberculous mycobacterial infection. In all 3 patients, IFN-gamma was undetectable following mitogen stimulation of whole blood, but significant quantities were detectable in the supernatants of PBMCs when stimulated in the absence of the patients' own plasma. The patients' plasma inhibited the ability of IFN-gamma to increase production of TNF-alpha by both autologous and normal donor PBMCs, and recovery of exogenous IFN-gamma from the patients' plasma was greatly reduced. Using affinity chromatography, surface-enhanced laser desorption/ionization mass spectrometry, and sequencing, we isolated an IFN-gamma-neutralizing factor from the patients' plasma and showed it to be an autoantibody against IFN-gamma. The purified anti-IFN-gamma antibody was shown to be functional first in blocking the upregulation of TNF-alpha production in response to endotoxin; second in blocking induction of IFN-gamma-inducible genes (according to results of high-density cDNA microarrays); and third in inhibiting upregulation of HLA class II expression on PBMCs. Acquired defects in the IFN-gamma pathway may explain unusual susceptibility to intracellular pathogens in other patients without underlying, genetically determined immunological defects.
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ranking = 97.720042360285
keywords = macrophage
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6/44. Disseminated Bacille Calmette-Guerin disease as the initial presentation of X-linked severe combined immunodeficiency--a case report.

    Bacille Calmette-Guerin (BCG) vaccination is used to prevent severe M. tuberculosis infection. It has been used in many countries for a long time. However, complications do occur, including localized abscesses, regional lymphadenitis and disseminated disease. The latter is often associated with underlying immunodeficiency. We report an 8-month-old male infant presenting with cough and fever who had had a generalized pigmented skin rash for one month. skin biopsy revealed mycobacterial infection, but his response to treatment was poor and he had a persistent mild fever. Immunological studies revealed an IgG of 49 mg/dl, IgA 4 mg/dl, IgM 28 mg/dl, IgE < 1 mg/dl, CD3 1.1%, CD4 0.6%, CD8 0.6%, CD19 93.9%, CD57 1.1%, activated T cells 0.9%, and CH50 < 6.3%. These findings are compatible with the diagnosis of T(-)B( )NK- severe combined immunodeficiency. sequence analysis was performed and showed the presence of missense mutation in IL2Rgamma gene. An X-linked recessive inheritance pattern was proved by sequence analysis of his mother and grandmother. In order to identify the strain of the microorganism, we reviewed pathology of the skin biopsy which consisted of diffuse histiocytic infiltrate with poorly formed granulomas and no necrosis and used polymerase chain reaction (PCR) with the stain-positive clinical specimen and verify the organism found in the child's biopsy as M. bovis BCG strain. The diagnosis of disseminated BCG disease must be considered in any infant with cutaneous mycobacterial lesions, especially with atypical histologic findings. Such a patient's immunologic status should be evaluated and further family study is suggested. A high index of suspicion is needed to make a timely diagnosis, as early intervention with intensive treatment and bone marrow transplantation may be life-saving.
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7/44. Description of Mycobacterium conceptionense sp. nov., a mycobacterium fortuitum group organism isolated from a posttraumatic osteitis inflammation.

    A nonpigmented rapidly growing mycobacterium was isolated from wound liquid outflow, bone tissue biopsy, and excised skin tissue from a 31-year-old woman who suffered an accidental open right tibia fracture and prolonged stay in a river. The three isolates grew in 3 days at 24 to 37 degrees C. 16S rRNA sequence analyses over 1,483 bp showed that they were identical and shared 99.7% (4-bp difference) sequence similarity with that of Mycobacterium porcinum, the most closely related species. Partial rpoB (723 bp) sequence analyses showed that the isolates shared 97.0% sequence similarity with that of M. porcinum. Further polyphasic approaches, including biochemical tests, antimicrobial susceptibility analyses, and hsp65, sodA, and recA gene sequence analysis, as well as % G C determination and cell wall fatty acid composition analysis supported the evidence that these isolates were representative of a new species. Phylogenetic analyses showed the close relationship with M. porcinum in the mycobacterium fortuitum group. The isolates were susceptible to most antibiotics and exhibited evidence for penicillinase activity, in contrast to M. porcinum. We propose the name Mycobacterium conceptionense sp. nov. for this new species associated with posttraumatic osteitis. The type strain is D16(T) (equivalent to CIP 108544(T) and CCUG 50187(T)).
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8/44. mycobacterium haemophilum osteomyelitis: case report and review of the literature.

    BACKGROUND: mycobacterium haemophilum is a slow-growing, fastidious, iron-requiring microorganism that, relative to other non-tuberculous mycobacterial species, has rarely been documented as a cause of human infection. This microorganism appears to be acquired via environmental exposure although its natural habitat and mode of acquisition are unknown. It has primarily been implicated as a cause of ulcerating cutaneous or subcutaneous nodular skin lesions, particularly in immunocompromised patients, although infections at extracutaneous sites have also been described. osteomyelitis, while rarely documented, appears to be an important complication of infection with M. haemophilum in these patients. CASE PRESENTATION: We describe a unique case of culture-confirmed M. haemophilum osteomyelitis in an adult woman with polycythemia vera and review the world literature on bone infections due to this organism. CONCLUSION: mycobacterium haemophilum is an important but infrequently encountered cause of osteomyelitis in immunocompromised patients, often requiring months to years of medical therapy, with or without surgery, to effect a clinical cure.
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9/44. Disseminated nontuberculous mycobacterial infections in sickle cell anemia patients.

    nontuberculous mycobacteria (NTM) are ubiquitous in nature and have been implicated in skin/soft-tissue, pulmonary, middle ear, bone, and surgical/traumatic wound infections. Disseminated disease occurs infrequently and almost exclusively in the immunocompromised. We describe the first 2 reported cases of disseminated mycobacterium fortuitum infection in teenagers with sickle hemoglobinopathy. Both had central venous catheters (CVCs), frequent admissions for vaso-occlusive painful episode and received hydroxyurea. diagnosis was confirmed by multiple positive blood cultures and pulmonary dissemination occurred in both. Both had successful treatment after CVC removal and combination drug therapy. Positive cultures persisted in 1 patient due to drug resistance emphasizing the need for accurate susceptibility data. NTM infection should be added to the list of pathogens in sickle cell patients with CVCs and fever. Investigation for disseminated disease should be undertaken based on clinical signs and symptoms. Although some routine blood culture systems can identify NTM, specific mycobacterial blood culture is optimal. Removal of involved CVCs is essential and treatment of NTM must be guided by susceptibilities. As dissemination almost always occurs in those with impaired cellular immunity, human immunodeficiency virus testing should be performed. hydroxyurea may be a risk factor for dissemination and needs further evaluation.
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10/44. An autopsy case of purulent mycobacterial meningitis in AIDS.

    The patient was a 46-year-old male hemophiliac who died of acute mycobacterial meningitis associated with AIDS (acquired immune deficiency syndrome). autopsy revealed severe basal meningitis which was characterized by an infiltration of numerous polymorphonuclear leukocytes. Severe mural inflammation of the subarachnoid arteries was noted, and innumerable acid-fast bacilli were demonstrated. Epithelioid cell granulomas were not found in the meningeal lesion. The lungs, liver, spleen, and bone marrow contained many epithelioid cell granulomas with caseous necrosis. Massive proliferation of swollen histiocytes could not be identified in any organ. The absence of epithelioid cell granulomas in the meningeal lesion indicate a severe impairment of cell-mediated immunity in the patient; this anergic type of lesion is one of the characteristics of tuberculosis occurring in association with terminal AIDS.
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